The Zero Marginal Cost Society: The Internet of Things, the Collaborative Commons, and the Eclipse of Capitalism (38 page)

With epidemics, tracking the spread of breakouts in real time is critical to controlling the disease. Being able to mobilize local health-care services, ensure that flu shots are available and quickly administered where needed, and alert the public makes a big difference in the severity of the outbreak. In the traditional surveillance system, it can take between one and two weeks to collect data from doctors around the country based on patients’ visits. By that time the flu virus could have peaked or even run its course. Google tracks peoples’ first response when they search the Web to see if their symptoms match those of the disease, often days before they call or visit their physician.

Twitter is also being looked to as a tracker. Twitter users send more than 500 million tweets per day. People who are not feeling well will often tweet their condition to friends, hours before the flu has disabled them, again providing an up-to-the-moment account of how the virus is spreading.

Epidemiologists, at present, assert that these early-warning tracking tools are complementary, or even supplementary, to the tried-and-true surveillance models. Yet there is a growing consensus that refining the algorithms to screen out noise and establish a more accurate reading of the data will make Google and Twitter surveillance and tracking more robust and the systems themselves more critical to the monitoring and containment of viral epidemics.
67
Using Big Data to track global epidemics and blunt contagions will save billions of dollars in health-care costs while the surveillance and reporting system heads to near zero marginal cost.

As researchers discover more about the links between genetic abnormalities and environmental triggers in the new field of genomic medicine, they’re learning that while illness can be broadly categorized—for example, breast cancer, leukemia, and lung disease—each individual’s illness is unique, even if diagnosed as part of a generally defined illness. Genetic medicine is at the forefront of a new customized approach to illness that treats each individual’s affliction as an “orphan” disease.

The diminishing cost of DNA sequencing is making available a library of Big Data that can be used by individuals to begin connecting with others who share a similar DNA profile. In the future, as DNA databases expand and the full sequence of human DNA becomes available for testing, millions of people will be able to match up with those
who share common inherited genetic traits in customized patient-driven health networks, and compare notes on illnesses and collaborate to find cures. These more customized patient-directed health Commons will also be able to create sufficient lateral scale to bring public attention to their disease cluster and encourage increased government, academic, and corporate research into their illnesses as well as raise funds for their own research, clinical trials, and treatment.

These DNA clusters of biologically matched individuals will also be able to use Big Data to cross-reference each other’s lifestyles—eating habits, smoking and drinking, exercise regimens, and work environments—to further correlate the relationship between genetic predispositions and various environmental triggers. Because the matched human clusters will include a chronology of life histories from in utero to old age and death, algorithms will undoubtedly be developed to pinpoint potential disease risks at various stages of one’s life as well as effective treatments.

By midcentury or earlier, I suspect that any individual will be able to access a global health Commons search engine, register their genetic makeup, find a matching cluster of similar genomes, and receive a detailed account of their health risks over a lifetime as well as a rundown of the most effective customized medical treatments to make them well and keep them well, at near zero marginal cost.

Organ transplants are among the most expensive medical procedures. Even here, new medical breakthroughs are opening up the possibility of significantly lowering the costs of organ replacements. If replacement tissues and organs are necessary, they will be able to be printed on a 3D printer, again at low or near zero marginal cost, in the not-too-distant future. Three-dimensional printing of human body parts is already well along. The Wake Forest Institute for Regenerative Medicine in North Carolina has recently printed a prototype human kidney using living cells.
68
Organovo, a San Diego-based Life Science company, has used 3D bioprinting to print a functioning section of human liver tissue.
69
Researchers at the ARC Centre of Excellence for Electromaterials Science at the University of Wollongong in Australia are experimenting using 3D processes to print muscle and nerve cells into living tissue. Cameron Ferris, a researcher at the ARC Centre, explains how bioprinting works: “We use the same technology as ink-jet printers, however instead of ink we are using cell types.”
70
Using the cells from a patient’s own body to reproduce the tissue, rather than implanting donor tissue, avoids rejection of the implant.

The 3D bioprinting of supplemental tissues, including heart patches, nerve grafts, blood vessel segments, and cartilage for degenerating joints, is expected to be in widespread use within the next ten years. The 3D bioprinting of complete organs will take a little longer.

Stuart Williams, a scientist at the Cardiovascular Innovation Institute in Louisville, Kentucky, is experimenting with taking fat-derived cells
extracted during liposuction and mixing them with glue to print a heart. Williams believes that a 3D-printed “bioficial” heart may be possible in ten years.
71
Gordon Wallace of the ARC Centre says that “by 2025, it is feasible that we will be able to fabricate complete functional organs, tailored for an individual patient.”
72
The brave new world of 3D bioprinted spare body parts will likely be a reality in the next several decades. As with other forms of 3D printing, the cost of replicating biological spare parts will plummet as the new technology scales up.

Today’s high-cost health care—much of which is primitive, ill-informed, and costly—will be a thing of the past in a Big Data culture and a near zero marginal cost society.

Like the democratizing of information on the Internet, the democratization of electricity on the Energy Internet, the democratization of manufacturing with open-source 3D printing, the democratization of higher education with MOOCs, and the democratization of exchange in the sharable economy, the potential democratization of health care on the Web adds one more layer to the social economy, making the Collaborative Commons an ever more prominent force in the affairs of society.

The End of Advertising

The shareable economy on the Commons is already forcing a fundamental restructuring of one of the key components of the traditional market-exchange economy. From the very beginning, advertising has been the driving force of the capitalist system. In the precapitalist era, when economic activity looked more like a flat line than an upward curve, human beings were conditioned to work just enough hours to secure their daily survival. Savings were virtually nonexistent. The onset of the Industrial Revolution brought with it a dramatic increase in material output and an accompanying increase in wages. Ensuring that those wages were quickly turned around and spent on consuming the goods workers produced became the mission of advertising. If there ever was an invisible hand, it is surely advertising’s ability to keep demand at pace with increasing supply. No small task.

Recall that until the early twentieth century, “consumption” had a negative connotation. It was the lay term for tuberculosis and the early dictionary definition of consumption was “to waste, pillage and exhaust.” It was only in the 1920s, with the advent of modern advertising, that consumption was given a makeover, turning it from a scourge to a social aspiration. The advertising industry reoriented the popular psyche, casting out an age-old tradition of frugality in favor of a new ethos that lauded the spendthrift over the skinflint. To be a consumer became the very mark of success and the epitome of what it meant to be thoroughly modern. By the second half of the century, consumer society began to overtake civil society as the primary community to which people owed their allegiance
and forged their social identity. It’s no mistake that immediately after the attack on the World Trade Center and the Pentagon on 9/11, President George W. Bush’s public response to a terrified nation was to announce that “the American economy will be open for business.” The president urged consumers to visit Disney World.
73

In 2012, the U.S. advertising industry brought in revenues totaling $153 billion. Global advertising revenues that same year totaled $479.9 billion.
74
While the advertising industry appears to be thriving, insiders are worried. What they see is millions of people shifting from passive consumers to peer-to-peer prosumers of their own news, knowledge, entertainment, and energy. (And soon, their own 3D manufacturing.) The same multitudes are minimizing their purchases in the marketplace by sharing already-bought items with others in the collaborative economy. They are choosing access over ownership and using everything from cars to sports equipment on a “just-in-time” basis. And virtually all this activity is being negotiated on an open Internet Commons where the marginal cost of exchanging information is nearly zero. A younger generation is quietly disengaging from the traditional capitalist market. It’s not yet a tidal wave, but the curve is exponential and likely irreversible.

This means that there is a diminishing consumer market for advertisers to exploit. And because the evolving social economy on the Commons is distributed, collaborative, and peer-to-peer, economic decisions are determined less by the sway of corporate advertising campaigns and more by recommendations, reviews, word of mouth, and likes and dislikes exchanged by “friends” and cohorts on Facebook, Twitter, YouTube, and hundreds of other social media sites online.

A spate of recent surveys reports that consumers place as much trust in consumer-generated reviews online as on recommendations from friends and family when it comes to purchasing decisions. Some 66.3 percent of consumers in one national survey say they rely “heavily” on user-
generated content reviews and recommendations when making purchasing decisions.
75
In the Local Consumer Review Survey in 2012, “72% of consumers said they trust online reviews as much as personal recommendations.”
76
Another survey found that 87 percent of consumers said a favorable online consumer-generated review sealed their decision to buy a product.
77
Even more revealing, “65% of consumers trust word of mouth on the Internet more than content produced by advertisers.”
78
Consumer-generated reviews are potentially important when people are deciding on which local business to use, with 52 percent saying that positive online reviews influence their decision.
79

Review websites abound on the Internet. Yelp, Angie’s List, Citysearch, TripAdvisor, Travelocity, Judy’s Book, and Local are among the hundreds of review sites where consumers check in to track other consumers’ experiences—positive and negative—with goods and services. Now these reviews can be viewed on location when consumers are
actually handling a product in the store. Consumr Reviews is a smartphone application that connects the phone directly with reviews of specific products. The user simply scans the barcode on the product into his or her cell phone and instantly accesses reviews of the item. Some of the new apps are even tied to the consumer’s own ethical value preferences. GoodGuide is a cell phone application that allows the consumer to scan the barcode and scroll down reviews on the screen to see how others rated the product on safety, health, ethical considerations, and general sustainability.
80
The increasing use of mobile apps will allow consumers to post their reviews of products and services online in real time, making them available to others within seconds after they have used the product or service.

When asked why they trust consumer-generated reviews over advertiser content, respondents in a survey conducted by SurveyMonkey cited lack of bias versus vested interest in comparing the trustworthiness of consumers versus advertisers. In a typical response, a respondent said he trusted customer-generated reviews over advertisers “because producers of most products tend to be really promotional in their product descriptions, and consumers have no vested interest in the sales of the product, so their reviews are inherently more trustworthy.”
81

Although it’s not uncommon for firms to game the system by posting anonymous favorable reviews of their own products and services or for competitors to post unfavorable reviews to hurt their rivals, they are the exception. Review sites are increasing their surveillance and monitoring devices and using ever more refined algorithms to weed out the fakes to protect their good name among consumers.
82

Traditional advertising is being whacked from every direction. Consider one of the mainstays of advertising—classified ads in newspapers and magazines. Craigslist was founded in 1995 by Craig Newmark to list local classifieds and forums online, largely for free. Craigslist is still listed online as a dot-org rather than a dot-com to reflect what the organization says is its “relatively noncommercial nature, public-service mission, and noncorporate culture.” More than 60 million people in the United States, along with millions more in 70 countries, use Craigslist each month—the website is in 13 languages—to search for jobs, housing, romance, and goods and services of all kinds. Craigslist users post 1 million classified ads each month, and its discussion forums attract 200 million people. Its entire operation is financed by tiny posting fees for jobs in 28 areas, and broker fees on New York City apartments.
83